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Re: Exhausted mom of 1 month old

Also she has been stirring on her own to wake up, that's a good sign right?

Yes, that is a good sign. That would be a good time to reward baby by offering to nurse, maybe expressing a little milk to get baby interested if needed.

She still falls asleep within 2 minutes of nursing, but can that get better?

Yes, it can get better and almost certainly will. I suggest keep doing all the things you have been doing to help baby stay awake-breast compressions, stroking, rubbing baby, jiggling chin, "pumping” (squeezing) baby’s hand or foot, switching sides....And also, if baby nurses a short time and falls asleep,. maybe try holding off on supplementing and nursing baby again very soon. I would be interested to see if baby is now able/willing to nurse longer if baby is more hungry.

The LC would like her to take in 2-2.5oz during nursing prior to me dropping supplements. How does that sound?

Of course that sounds reasonable. That is an average entire feeding at the breast (after about age 2 weeks or so.)

BUT -normal intake will vary tremendously session per session, from very little-a 1/2 ounce maybe, or even less- to 2-3 ounces at this age. (Going up to maybe 4 ounces or so at the top end when baby is a bit bigger.) So going only by before and after nursing weight checks, we only know what baby took at those specific sessions.

Also, how much a normal, healthy, gaining baby takes in per day varies tremendously. Generally, a breastfed one month old would normally take in an amount between 20 and 30 ounces per day. (it will eventually go up to top end about 35-40 ounces at very most-but many babies never take in nearly that much and stay more around 20 ounces per day.) But for the sake of this discussion, let’s assume that 25 ounces would be good intake right now for your baby.

If baby was taking in exactly 2.5 ounces per session, that would mean baby needs to nurse 10 times per day to get 25 ounces. But many 4 week old babies nurse much more often than that, while taking in a variety of amounts per session.

This is why before and after nursing weight checks are helpful but should not (imo) be the final determination when weaning baby off supplements.

Finally the pediatrician has warned me about abruptly stopping supplements, instead they should be gradually weaned off. That makes sense to me

Of course, it makes sense to gradually wean baby from supplements. I would certainly agree. But remember, in your case, you are supplementing entirely with your own expressed milk. Much of the caution about weaning gradually off supplements is for babies who are also receiving formula supplements because their mother’s milk production is not where it needs to be yet. So while I would agree it makes sense to take things gradually, you may be able to move more quickly than in those situations.

But to answer your question, there have been surmises as to why she is so sleepy: born preterm/ c section/ but everyone expected her to catch up by 1 months time.

imo these would explain why a baby of less than 2 weeks is so sleepy. I am wondering if there are any other possible issues causing baby to not be able to nurse effectively or stay wakeful at the breast. Tongue tie or any other barrier to a good latch, very slow letdown, that kind of thing.

Also I think we talked about this but just a reminder to anyone else with a similar issue-swaddling and pacifiers are sleep aids. If baby is so sleepy baby is not waking frequently enough to nurse, it may be helpful to stop or pull back on swaddling or pacifiers.

And skin to skin contact and/or baby spending lots of time “on” mom can help a lot too. Its hard to do this when pumping so much, I know. But the more baby nurses, the less you will have to pump.

Re: Exhausted mom of 1 month old

BTW, in my eagerness to try to answer your questions as best I can, I am afraid I am coming across as very clinical, but hopefully not critical!

You are doing so well. I know you are exhausted but I see good progress from when you first posted when your baby was about a week old. It sounds as if you have good, supportive breastfeeding help. That is so important! Plus through your monumental efforts, have maintained normal production, and baby is nursing at the breast. All of these are very good indications that you and baby will get through this and go on to nursing as long as you like.

Re: Exhausted mom of 1 month old

An update: was asked to see a pediatric ENT by myLC since she wasn't happy with my baby's latch, she clicks her tongue often, and looses suction esp as the breast gets softe, from Brest compressions. Turns out baby has a recessed jawline, high palate, and a tongue that doesn't roll out all the way to complete the suck. I have been supplementing more wuth the bottle, since she is only on the breast for 3minutes or so and I have developed mastitis.
Any suggestions how to nurse a baby with a High palate?

Re: Exhausted mom of 1 month old

Patience and fortitude. New babies have trouble getting a good latch even when their mouths/palates/tongues are 100% "perfect". But they generally get better with time, as they and their mouths grow and they become stronger and more adept at the breast.

My firstborn had a very high palate and it did cause problems in the beginning. But she grew out of it. The first few months were pretty rough. But we went on to have a very satisfying nursing relationship.

Re: Exhausted mom of 1 month old

I have been supplementing more wuth the bottle, since she is only on the breast for 3minutes or so and I have developed mastitis.

Just to clarify-you are not bottle feeding more BECAUSE you developed mastitis, are you?

Is the mastitis being treated?

Your LC will probably have a book called Supporting Sucking Skills in Breastfeeding Infants, and now that she knows more about what the problem is, should be able to find ideas for you there or consult with other LC's for ideas specific to your situation.